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Racial disparities among patients with lung cancer who were recommended operative therapy.

Publication ,  Journal Article
Farjah, F; Wood, DE; Yanez, ND; Vaughan, TL; Symons, RG; Krishnadasan, B; Flum, DR
Published in: Arch Surg
January 2009

HYPOTHESIS: Health care system and provider biases and differences in patient characteristics are thought to be prevailing factors underlying racial disparities. The influence of these factors on the receipt of care would likely be mitigated among patients who are recommended optimal therapy. We hypothesized that there would be no significant evidence of racial disparities among patients with early-stage lung cancer who are recommended surgical therapy. DESIGN, SETTING, AND PATIENTS: Retrospective cohort study of patients in the Surveillance, Epidemiology, and End Results-Medicare database who were diagnosed with stage I or II lung cancer between January 1, 1992, and December 31, 2002 (follow-up through December 31, 2005). MAIN OUTCOME MEASURES: Receipt of lung resection and overall survival. RESULTS: Among 17,739 patients who were recommended surgical therapy (mean [SD] age, 75 [5] years; 89% white, 6% black), black patients less frequently underwent resection compared with white patients (69% vs 83%, respectively; P < .001). After adjustment, black race was associated with lower odds of receiving surgical therapy (odds ratio = 0.43; 99% confidence interval, 0.36-0.52). Unadjusted 5-year survival rates were lower for black patients compared with white patients (36% vs 42%, respectively; P < .001). After adjustment, there was no significant association between race and death (hazard ratio = 1.03; 99% confidence interval, 0.92-1.14) despite a 14% difference in receipt of optimal therapy. CONCLUSIONS: Even among patients who were recommended surgical therapy, black patients underwent lung resection less often than white patients. Unexpectedly, racial differences in the receipt of optimal therapy did not appear to affect outcomes. These findings suggest that distrust, beliefs and perceptions about lung cancer and its treatment, and limited access to care (despite insurance) might have a more dominant role in perpetuating racial disparities than previously recognized.

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Published In

Arch Surg

DOI

EISSN

1538-3644

Publication Date

January 2009

Volume

144

Issue

1

Start / End Page

14 / 18

Location

United States

Related Subject Headings

  • White People
  • Survival Rate
  • Surgery
  • Retrospective Studies
  • Pneumonectomy
  • Male
  • Lung Neoplasms
  • Humans
  • Healthcare Disparities
  • Female
 

Citation

APA
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MLA
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Farjah, F., Wood, D. E., Yanez, N. D., Vaughan, T. L., Symons, R. G., Krishnadasan, B., & Flum, D. R. (2009). Racial disparities among patients with lung cancer who were recommended operative therapy. Arch Surg, 144(1), 14–18. https://doi.org/10.1001/archsurg.2008.519
Farjah, Farhood, Douglas E. Wood, N David Yanez, Thomas L. Vaughan, Rebecca Gaston Symons, Bahirathan Krishnadasan, and David R. Flum. “Racial disparities among patients with lung cancer who were recommended operative therapy.Arch Surg 144, no. 1 (January 2009): 14–18. https://doi.org/10.1001/archsurg.2008.519.
Farjah F, Wood DE, Yanez ND, Vaughan TL, Symons RG, Krishnadasan B, et al. Racial disparities among patients with lung cancer who were recommended operative therapy. Arch Surg. 2009 Jan;144(1):14–8.
Farjah, Farhood, et al. “Racial disparities among patients with lung cancer who were recommended operative therapy.Arch Surg, vol. 144, no. 1, Jan. 2009, pp. 14–18. Pubmed, doi:10.1001/archsurg.2008.519.
Farjah F, Wood DE, Yanez ND, Vaughan TL, Symons RG, Krishnadasan B, Flum DR. Racial disparities among patients with lung cancer who were recommended operative therapy. Arch Surg. 2009 Jan;144(1):14–18.

Published In

Arch Surg

DOI

EISSN

1538-3644

Publication Date

January 2009

Volume

144

Issue

1

Start / End Page

14 / 18

Location

United States

Related Subject Headings

  • White People
  • Survival Rate
  • Surgery
  • Retrospective Studies
  • Pneumonectomy
  • Male
  • Lung Neoplasms
  • Humans
  • Healthcare Disparities
  • Female